spiral2grow, a leading provider of dialectical behavioral therapy (DBT) in New York City, has professionals that include dialectical behavioral psychotherapists and behavioral cognitive counselors, who are expert in DBT. spiral2grow, located in midtown Manhattan at 260 Madison #8023, New York, NY 10016, offers DBT treatment for self esteem, DBT counseling for anger management, social anxiety and general anxiety. DBT setting can is provided through individual counseling as well as DBT group counseling.

Dialectical Behavioral Therapy (DBT) – Overview

Dialectical Behavioral Therapy (DBT) is a combination of multiple methodologies, mainly Cognitive Therapy and Behavioral Therapy, Acceptance Commitment Therapy as well various mindfulness practices and Eastern psychology techniques. DBT is drawn from Zen Buddhism and mindful techniques that lead to acceptance and Cognitive Behavioral Therapy that lead to a dramatic change. The main purpose of DBT is to manage stress and build a better quality of life, through the acquisition of new views and adapt healthy cognitive and behaviors skills.

DBT maintains that some people (due to biological and environmental reasons) react in an unhealthy way to emotional stimulation. Their level of arousal goes up quickly to a high level (which is challenging to deal with), and takes long time to return to baseline. Because of their past invalidation, these people don’t have the necessary skills to manage with these sudden, intense emotions. DBT is set of skills that will help in this task. It promotes techniques for emotional regulation and well being.

DBT is a structure model that helps streamline decision making and build healthy skills. The DBT method integrates mindfulness, motivational techniques and range of emotional regulation as well as interpersonal skills in a customizable way that leads to healthy living.

What DBD promotes

DBT assume that successful psychotherapy promotes the following aspects:

• It enhances and maintain the client’s motivation to change;
• It improves the client’s capabilities;
• It ensures that the client’s new capabilities are generalized to all relevant environments;
• It promotes the therapist’s motivation to treat clients while also enhancing the therapist’s capabilities;
• and, it structures the environment so that treatment can take place.

Skills are acquired, strengthened, and generalized through the combination of individual psychotherapy, group work, homework assignments as well as coaching.

The Four Modules OF DBT

Mindfulness

Mindfulness is paying attention on purpose to what is happening right now. When you practice mindfulness, you focus your attention on your present experience; just noticing whatever is happening in each moment, not lost in the past or thinking about the future.
Interpersonal Effectiveness

Interpersonal response patterns taught in DBT skills training are very similar to those taught in many assertiveness and interpersonal problem-solving classes. They include effective strategies for asking for what one needs, saying no, and coping with interpersonal conflict.
Distress Tolerance

Distress tolerance skills constitute a natural development from mindfulness skills. They have to do with the ability to accept, in a non-evaluative and nonjudgmental fashion, both oneself and the current situation. Although the stance advocated here is a nonjudgmental one, this does not mean that it is one of approval: acceptance of reality is not approval of reality.

Distress tolerance behaviors are concerned with tolerating and surviving crises and with accepting life as it is in the moment. Four sets of crisis survival strategies are taught: distracting, self-soothing, improving the moment, and thinking of pros and cons. Acceptance skills include radical acceptance, turning the mind toward acceptance, and willingness versus willfulness.

Emotion Regulation

Dialectical behavior therapy skills for emotion regulation include:

• Identifying and labeling emotions
• Identifying obstacles to changing emotions
• Reducing vulnerability to “emotion mind”
• Increasing positive emotional events
• Increasing mindfulness to current emotions
• Taking opposite action
• Applying distress tolerance techniques

DBT (Dialectical Behavioral Therapy) Skills

1. WISE MIND
   Use your wise man “inside of you.” When you are balanced between emotional mind and reasonable mind…You are not allowing your emotions to control you, but at the same time you are still allowing yourself to feel the emotions.
2. OBSERVE
   Witness, sit back and observe your emotion. How is it making you feel physically and emotionally?
3. DESCRIBE
   Use affirmation and tell yourself in words how it is making you feel.
4. PARTICIPATE
   Feel your feelings – allow yourself to feel the emotion, just don’t hold on to it, let it go. Don’t stuff it inside and not feel it at all either.
5. NONJUDGEMENTAL STANCE
   Be non-judgmental – don’t judge yourself or others. Don’t let yourself think that an emotion has to be either good or bad…just remember it is your emotion and it just is…
6. FOCUS ON THE PRESENT
   Don’t worry or dwell about the past or the future. Just concentrate on the here and now.
7. BE EFFECTIVE AND USEFUL
   Think of long-term benefit and focus on what works for you. Don’t try to rush, or you will get overwhelmed, just focus on doing things the way you know they will work for you.
8. OBJECTIVE EFFECTIVENESS (DEAR MAN)
   This is an acronym to be able to work out a problem with someone you are upset with. Here is the meaning of DEAR MAN:
   D= describe what is bothering you.
   E= express how the situation is making you feel.
   A= assert yourself, don’t assume that they already know what is wrong with you, tell them.
   R= reinforce. Let the person know how important it is for you to be heard…
   M= stay mindful. If you have to make yourself sound like a broken record. Don’t allow the person to go into another topic, stay on the discussion at hand…
   A= appear confident. Even if you don’t feel confident inside, if you look confident on the outside, the person will be more willing to listen to you…
   N= negotiate. Try to compromise and come up with a solution that you both can agree on.
9. RELATIONSHIP EFFECTIVENESS (GIVE)
   Another acronym to try and keep a discussion with a loved one calm:
   G= be gentle. Be courteous in your approach. Don’t come off screaming and yelling.
   I= interested. Seem interested in what the other person has to say and listen to their point of view…
   V= validate. Let the other person know that you understand how they are feeling also…
   E= easy manner. Put a little humor into the discussion. It makes both people feel more at ease to talk.
10. SELF-RESPECT EFFECTIVENESS (FAST)
    Another acronym for allowing yourself to not be used and taken for granted.
    F= be fair to yourself and the other person. Don’t be judgmental…
    A= no apologies. We tend to OVER apologize. Try to keep the apologies out.
    S= stick to your values. Don’t allow yourself to change your feelings to make the other person happy.
    T= be truthful. Don’t lie to yourself or the other person. You have your own mind, use it. Don’t think that you need to let other people make up your mind for you to please them.
    11.REDUCE VULNERABILITY (PLEASE)
    Additional acronym to keep yourself feeling good physically and mentally so you aren’t as vulnerable to stressful situations.
    P & L= treat physical illness. If you are sick, go see a doctor, get the help you need to feel better….
    E= balance eating. Your body feels good if you eat right. Don’t eat too much and don’t eat too little…
    A= avoid mood altering drugs. Staying away from drugs, alcohol, caffeine, sugar and such also makes you stay clear headed and feeling better….
    S= balance sleep. Again like food, sleep is important. Make sure you don’t get too much sleep and make sure you get enough sleep…
    E= get exercise. Exercise is a good way to relieve stress and makes you feel better inside. I love to walk.
11. BUILD MASTERY
    Practice, practice, practice. Whenever you do anything at all that makes you feel like you are in positive control or that you accomplished something, you have used build mastery. Focus on improving your skill, clean negative habits and build mastery.
12. BUILD POSITIVE EXPERIENCE
    Enjoy life. For examples, go visit a friend or a family member, help someone out, contribute to other, have fun, connect to nature, build positive memories, follow your passions etc.
13. OPPOSITE-TO-EMOTION
    Cultivate the opposite and do something you don’t want to do. Like if you know you need to go to the store or to an appointment, but you don’t want to. If you do go, then you are using opposite to emotion. Some people who are feeling sad put in a comedy movie to try and lift their spirits. This is also opposite to emotion.
14. DISTRACT
    When you cannot tolerate the situation distract yourself. If you are feeling stressed and too overwhelmed to deal with a current situation, go read a book or play the computer or take a walk to distract your mind until you can calm down and come back to handle the situation. Be careful…using this skill to an extreme can be a result of stuffing your feelings and not just distraction.
15. SELF-SOOTHE
    Calm yourself and do something that makes you feel good. They say to do something to use each of your senses. Taste, smell, touch, sight and sound.. but to me, anything that makes me feel good inside I consider self-soothing.
16. IMPROVE THE MOMENT
    Use prayer, meditation, or just sit and concentrate on your breathing, or just picture a nice place in your head to try and calm yourself down, when you feel overwhelmed.
17. PROS AND CONS
    Make a cost benefit analysis. Prepare a list of the pros of a current situation and of the cons to help you decide what you should do.
18. RADICAL ACCEPTANCE
    This is a lot like the Serenity prayer…you use this to accept the fact that some things, you just can’t change. Allow yourself to accept that your feelings are yours and you have a right to them. They are not good or bad they just are…
    Part of the serenity prayer:
    Grant me the serenity to accept the things I cannot change; the courage to change the things I can; and the wisdom to know the difference. Living one day at a time; enjoying one moment at a time; accepting hardships as the pathway to peace.

Lean more about other psychotherapy modalities by spiral2grow.